Reliability of the Matson Evaluation of Drug Side Effects Scale (MEDS).

The potential negative effects of psychoactive medication are well documented. Given the high rate of their use in persons with mental retardation, the need to assess and identify these negative effects is great. The Matson Evaluation of Drug Side Effects (MEDS) was designed to evaluate commonly identified side effects with a psychometrically sound checklist. The initial psychometric properties of this scale are presented and discussed. An examination of interrater reliability and internal consistency revealed that the MEDS has excellent consistency across raters and good internal consistency. Potential uses for the scale and directions for future research are reviewed as well.

Pitfalls in the use of high energy X rays to treat tumors in the lung.

The problem of central axis dose reduction for high energy photon beams of small cross-sectional area traversing normal lung tissue is well known. An additional problem, which may be not as well appreciated, is the loss of electronic equilibrium on the periphery of high energy photon beams, resulting in an increase in the penumbra occurring in lung. We have compared profiles of x-ray beams ranging in energy from 4 MV to 18 MV. The profiles were measured at 10-cm depth in unit-density and lung-density (0.26) phantoms. At the highest energy the 20% to 80% physical penumbra width was measured to be 7.5 mm in the unit-density material, whereas in the lung phantom the width was 18 mm. At 4 MV the situation was reversed; that is, the penumbra was slightly smaller in the lung phantom. Most computer programs for radiation therapy treatment planning do not take into account this change in beam profile when calculating dose in the lung. As a result, unanticipated underdosing inside the field and greater dose outside the field can occur when high-energy X rays are used.

Cooperative regional program for distribution of poison prevention information and syrup of ipecac.

A regional program to distribute poison prevention information and syrup of ipecac to families that have regular contact with young children is described. In December 1985 the department of pharmacy services at Bristol Hospital in Connecticut proposed implementation of a poison prevention program targeted to families with young children (less than 12 years of age) in the hospital's five-town service area. A planning committee was created to define program goals and oversee operations. The committee decided that poison prevention kits consisting of an instructional booklet and a one-ounce bottle of syrup of ipecac would be distributed to selected residents of the five-town area, with individual instruction provided in the correct use of syrup of ipecac. Funding was provided principally by the hospital, with some additional money from private foundations. The project was named CAP (Combating Accidental Poisoning) and ran initially from December 1, 1986, to June 30, 1987. Kits were distributed in cooperation with area health-care professionals with whom families had regular contact, including pediatricians, family-practice physicians, and community pharmacies. Apart from the hospital pharmacy service itself, the most effective participants were pediatricians; family-practice physicians were highly ineffective. During the course of the initial CAP program 6610 kits were distributed, with 48.7% going to families considered at high risk for the occurrence of an accidental child poisoning. An ongoing program to distribute these kits to all newly delivered mothers and to all area pediatricians free of charge has resulted in more than 15,000 kits being distributed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma of the appendix.

The experience in Hamilton, Ontario, with adenocarcinoma of the appendix, between 1974 and 1980, is reviewed and the findings are compared with those of a previous report from Hamilton. There were seven patients (five men and two women) in the current series. The average age was 55.6 years. The unusual presenting signs and symptoms of this tumour are noted; the diagnosis is rarely made preoperatively. This tumor often cannot be distinguished from cecal or ileal malignant tumours. Detailed histologic examination of all specimens is essential to identify epithelial types and to plan treatment. While appendectomy alone may suffice for tumours confined to the appendiceal mucosa, radical right hemicolectomy is still the standard therapy. The authors' study shows no improvement in preoperative diagnosis, or in prognosis, over the earlier report. The authors recommend (a) that this condition be considered in the diagnosis of any appendiceal mass that is not obviously inflammatory, and (b) the frequent use of frozen-section examination to confirm the diagnosis.

An economical mobile intensive care unit.

A mobile intensive care unit is an important extension of a regional intensive treatment service. The treatment and monitoring of critically ill patients can be maintained during transfer for specialist investigation or treatment. Such units can be brought into service with low construction and running costs.

A simple method of protecting the eye from scattered radiations during mantle-field therapy.

The intensity and quality of scattered radiations incident on the eye during mantle-field therapy were measured for 4-MV x rays. Beam-shaping appliances were found to introduce considerable soft scatter. Eye shields reduce radiation exposure from the anterior field approximately threefold.